Q&A With CHIME Public Policy Award Recipient Randy McCleese, Chapter 1

If you want to drive real change, you’re going to have to get personal. It’s one of many lessons Randy McCleese has learned during his career, both as CIO at St. Claire Regional Medical Center, and as a member of CHIME’s Policy Steering Committee. Rather than just present Congressional leaders with facts and figures, McCleese describes the challenges that his and other rural organizations face in meeting complex regulatory requirements, and it’s made a difference. In this interview, he talks about the work his team has done during the past few years, and what they hope to accomplish in the future. McCleese also touches on the difficulties facing vendors, the value in partnering with outside organizations, and why CIOs need to be more strategic.

Chapter 1



* Winning CHIME’s Federal Public Policy Award — “It’s a group effort.”

* Challenges of small & rural providers

* “Physicians want to practice medicine.”

* MACRA/MU concerns: “We have to make sure the workflows we’re designing can provide quality measures.”

* The “cumbersome” job of getting EHRs to talk

* Innovation on hold

* St. Claire’s postponed EHR update



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Bold Statements

Over the past 12 to 15 years, what we’ve noticed is that the physicians want to practice medicine. They don’t want to be in this business where they’re having to deal with regulations and making sure they’re getting all the reporting and everything done.

As we move from MU into MACRA and all the things that are happening there, we’re finding that we have to go to them and get them more involved to make sure that as we change workflows, the workflows that we’re designing can provide us the quality measures that we have to be able to report.

Each physician, group of specialists, and clinic has developed workflows over time that they are extremely reluctant to give up on. And because we are moving to electronic records and we’re trying to standardize how practice is done, how the patients are taken care of, it’s difficult for them to give that up. So it’s a cultural change.

How do we push our vendors to make sure that what’s coming out of Washington is better for them because it allows us to do a better job of taking care of the patient, instead of looking at it just as we’ve got to meet the regulations and the regulatory requirements?

Gamble:  First off, I want to congratulate you on winning the CHIME’s Federal Public Policy Award. That’s a great honor.

McCleese:  Thank you. As I told one of the folks on policy steering committee, it’s been a group effort, especially, thanks to the CHIME staff in Washington I’ve worked with over the years: Sharon Canner, Jeff Smith, Leslie Kriegstein, and Mari Savickis. They’re wonderful people to work with; that’s what keeps me going.

Gamble:  I want get into some of the work being done, but I think a good way to start is to talk about some of the challenges that providers in small and rural communities are facing when it comes to meeting the regulatory requirements and even staying afloat.

McCleese:  We are a regional medical center, and over the past 12 to 15 years, what we’ve noticed is that the physicians want to practice medicine. They don’t want to be in this business where they’re having to deal with regulations and making sure they’re getting all the reporting and everything done that’s required. In our community, there were two major groups outside the hospital — they were associated with the hospital because they did work here. One of them came to us in 2004 and the other one came in 2011, and they wanted to merge with the hospital. And their main reason was too many regulations coming at them. It was just too cumbersome and burdensome for them to have to get out there and take care of...